A man with an intellectual disability who has a phobia of the dentist had to have 24 teeth pulled as part of a procedure under general anaesthetic sanctioned by the High Court.
On Friday Mr Justice Barry O’Donnell said doctors reported that the dental procedure went “as expected” and that the young man appears to be “significantly” more comfortable.
He was informed that such a high number of teeth had to be removed due to decay, necrosis and pus present in the man’s mouth.
The Health Service Executive’s (HSE’s) barrister, Donal McGuinness, noted the man had a “pathological fear” of the dentist and the urgent orders providing for treatment under general anaesthetic had been necessary due to concerns he would develop sepsis.
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The judge’s orders from two weeks ago permitted the hospital to provide all “necessary” medical treatments for his best welfare. These included, but were not limited to, potential dental surgery, tube feeding and general anaesthesia.
The medical evidence before the court was that the man lacked the mental capacity to make health decisions in his best interest.
In a sworn statement to the court two weeks ago, a consultant doctor said the man began to complain of tooth pain in September and was brought to a dentist. He said the dentist could not do a complete examination but reported she could see swollen gums, rampant decay and pus coming through some areas for decayed teeth.
The doctor said the man reportedly began to decline food and drink and his mood deteriorated. He was brought to hospital by ambulance last month after refusing food or hydration for 34 hours. He was given fluids and antibiotics but he later declined medications and examination.
The doctor said the man has lost weight while on the ward and that his oral infection could be causing a delirium and behavioural change. The consultant and a psychiatrist both believed the man is unable to weigh the risks that arise from continued non-treatment.
On Friday, Mr McGuinness asked the court to continue its treatment orders for a further two weeks. He said the man needed antibiotics after the procedure and may need to be sedated further in aid of his recovery.
The barrister, instructed by Byrne Wallace solicitors, said he will return to court “immediately” seeking an end to the orders if the man becomes ready for hospital discharge before the case is due to return.
Solicitor James Bardon, who was appointed as the man’s advocate in court, said the man’s family is very happy with how the operation went. Mr Bardon said he recently visited the man and he was “noticeably more comfortable” than before the procedure.
He said the man is getting excellent care and is now permitting nurses to clean his teeth. Mr Justice O’Donnell said that this is a “significant development from where he was before”.
The judge made orders allowing doctors to provide whatever treatment is necessary to aid his care, rehabilitation and recovery. He said the need for the court’s intervention will “fall away in the reasonably near future, all going well”.
He adjourned the case for three weeks.
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